Understanding Dog Bites and Their Risks

Dog bites can be unpredictable and potentially deadly. According to the Centers for Disease Control and Prevention (CDC), approximately 4.5 million people are bitten by dogs each year in the United States.

Most dog bites occur on the arms, hands, and face, which can result in serious injuries and even infections. The CDC also reports that children are more likely to be bitten by dogs than adults.

In the United States, dog bites are a leading cause of emergency room visits, with over 20,000 people requiring reconstructive surgery each year.

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Dog bites can happen to anyone, but some groups are more susceptible than others. Infants and children are more likely to be bitten, and among children, the rate of dog-bite-related injuries is highest for those five to nine years old.

Dogs can be territorial and protective, and may attack anyone who poses a threat to their companions. Some dogs are highly territorial and will bark, growl, snap, and lunge if outsiders enter their space.

Most dog bites occur in children, and they're far more likely to be seriously injured than adults. This is often because people don't always heed the behavioral signals that a dog is uncomfortable.

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Dogs bite people as a reaction to feeling stressed, threatened, scared, or startled. Most dog bites happen in children, who are far more likely to be seriously injured than adults.

Some dogs are highly territorial and will bark, growl, snap, and lunge if outsiders enter their space. This can be a high-risk situation, especially for children who may not be aware of the risk.

Dogs may also exhibit resource guarding, which shows up as anxious, aggressive behavior around food, toys, or beds. This behavior can be a sign that a dog is uncomfortable.

People often don't heed the behavioral signals that a dog is uncomfortable, which can lead to bites.

Prevention is key when it comes to dog bites. Any dog can bite if provoked, so it's essential to take precautions.

Always ask a dog's owner if it's okay to pet their dog, even if the dog appears friendly. Make sure the dog sees and sniffs you before reaching out to pet it. Don't pet a dog that seems to be hiding, scared, sick, or angry.

If an unfamiliar dog approaches you, remain calm and still, avoiding eye contact with the dog. Stand with the side of your body facing the dog and say "no" or "go home" in a firm, deep voice. Wait for the dog to retreat or move yourself slowly away.

In fact, 88% of facial dog bites treated at Harvard-affiliated Massachusetts General Hospital over a 20-year period were from known dogs. Most were in adults and occurred after playing with the dog, feeding the dog, and placing their face close to the dog.

Here are some additional tips to prevent dog bites:

By taking these precautions, you can significantly reduce the risk of being bitten by a dog.

If you're bitten by a dog, clean the wound with mild soap and running water, then cover it with a clean bandage or cloth. You should also get the dog's owner's contact information and make sure the dog is vaccinated against rabies.

If the injury is serious, such as a bite on the face, heavy bleeding, or a possible broken bone, go to the emergency room. This is also a good idea if you're bitten by an unknown or stray dog, in case you might need medicines to prevent rabies.

You should get the person's contact information and make sure the dog is vaccinated against rabies, says Dr. Baugh.

Emergency rooms are often crowded with long waits, so an urgent care clinic is a good option if the injury doesn't require immediate attention. If you do go to the emergency room, be prepared for a wait.

Some wounds require stitches, ideally within 12 to 24 hours. You may also need a tetanus booster if you haven't had one in the past 10 years.

Here are some things to keep in mind:

A doctor may prescribe antibiotics to prevent possible infections, especially if you have health problems such as a weakened immune system or diabetes.

A dog bite can be a painful and potentially serious injury, but most wounds can be treated effectively with proper care. If a dog bite breaks the skin, cleaning the wound with mild soap and running water is essential to reduce the risk of infection.

Only 15 to 20 percent of dog bite wounds become infected, but certain types of wounds are more prone to infection, such as crush injuries, puncture wounds, and hand wounds. The most common aerobic organisms found in infected dog bite wounds are Pasteurella multocida and Staphylococcus aureus.

Treatment with prophylactic antibiotics for three to seven days is often recommended, unless the risk of infection is low or the wound is superficial. Amoxicillin-clavulanate potassium (Augmentin) is the antibiotic of choice for dog bites, but alternative options are available for patients allergic to penicillin.

If you're unsure about the severity of the wound or the dog's rabies vaccination status, it's best to err on the side of caution and seek medical attention. A doctor can examine the wound, prescribe antibiotics if necessary, and provide guidance on how to prevent infection.

The American Academy of Pediatrics recommends a booster tetanus vaccine for people with dirty wounds if more than 5 years have passed since their last shot.

Discover more: Types of Dog Bite Wounds

If you're unsure about the severity of a dog bite, it's always best to err on the side of caution and seek medical attention.

If you notice uncontrollable bleeding from the wound, seek emergency medical attention immediately.

A fever can be a sign of infection, so if you develop a fever after a dog bite, see a doctor right away.

A red, swollen, or painful wound is a clear indication that something's not right, and you should seek medical attention.

If your wound feels warm to the touch, it could be a sign of infection, and you should see a doctor.

If you have a deep wound and haven't had your tetanus shot within the last 5 years, you should seek emergency treatment.

Here are some specific situations that require emergency medical attention:

If you're unsure whether the dog has received a rabies vaccine or was acting strangely, it's best to seek medical attention to be safe.

Treatment for a dog bite is crucial to prevent infection and promote healing. If the skin is broken, it's essential to clean the wound with mild soap and running water, then evaluate it with your regular healthcare provider.

Most dog bite wounds can be treated with prophylactic antibiotics for three to seven days, unless the risk of infection is low or the wound is superficial. Amoxicillin-clavulanate potassium (Augmentin) is the antibiotic of choice for a dog bite.

Clean, minor wounds can often be treated at home with soap and water, but it's still important to see a doctor for more serious wounds. A doctor may use a syringe to apply water and a cleaning solution to the wound, and then prescribe antibiotics to fight off any bacteria that have entered the body.

If you have a dirty wound, you may need a booster tetanus vaccine if more than 5 years have passed since your last shot. For a clean wound, you should have a booster vaccine if it has been more than 10 years since your last shot.

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A Cochrane review found that there is not much evidence for or against current practices of keeping dog bite wounds left open to heal for a short time before closure (delayed closure) or not stitched at all (no closure) over immediate closure by stitching. However, stitches may be necessary for severe or facial wounds.

Some people may be at higher risk of infection, including those with crush injuries, puncture wounds, or hand wounds. In these cases, treatment with prophylactic antibiotics for three to seven days is often necessary.

The most common aerobic organisms found in infected dog bite wounds are Pasteurella multocida and Staphylococcus aureus, occurring in 20 to 30 percent of infected dog bite wounds. Other possible aerobic pathogens include Streptococcus species, Corynebacterium species, Eikenella corrodens, and Capnocytophaga canimorsus.

If you experience any of the following symptoms, seek emergency medical attention: uncontrollable bleeding from the wound, a fever, a red, swollen, or painful wound, a wound that feels warm, a deep wound and have not had your tetanus shot within the last 5 years, or damage to the nerves or bones.

Here is a table summarizing tetanus prophylaxis recommendations:

Canalicular lacerations are common injuries from periocular dog bites. They occur more frequently in eyelid lacerations caused by dog bites compared to other mechanisms.

Stretching of the eyelid results in shear forces at the canaliculus, which is the weakest point of the eyelid.

Puncture wounds in the canaliculus area can also cause canalicular lacerations.

Repair with silicone intubation is the recommended treatment for this type of injury.

Dog bites can have serious health consequences, including the risk of rabies, which results in the death of approximately 55,000 people per year.

The risk of rabies is higher if the dog is not vaccinated, and if you're bitten by a nonprovoked dog, you should be considered at higher risk for rabies infection. If the dog owner is reliable and can confirm the animal's vaccination status, the dog may be observed at home, but if not, you should receive rabies immunization.

Rabies immunization typically begins within 48 hours after the bite and consists of an active immune response with a vaccine and a passive immune response with rabies immune globulin (RIG). The treatment regimen varies depending on your vaccination status, and guidelines are provided in Table 3.

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Risk Factors for Dog Bites:

Soft tissue infections after dog bites to the head and neck are less than 5% in most studies, but can be catastrophic if they occur due to the rich vascular supply to the area.

Rabies results in the death of approximately 55,000 people per year, with most of the causes due to dog bites.

Dog bites can also transmit other infections, such as Capnocytophaga canimorsus, MRSA, tetanus, and Pasteurella.

Infection with B. zoohelcum from dog bites can lead to bacteremia, an emerging infection transmitted through dog bites.

Soft tissue infections after dog bites to the head and neck are relatively rare, occurring in less than 5% of cases.

The risk of infection in this area is higher due to the potential for pathogens to access the intracranial space through the valveless venous supply to the face.

A canine mouth can harbor over 64 species of bacteria, including aerobic and anaerobic bacteria, which can lead to polymicrobial infections.

Common organisms found in dog bites include Pasteurella, Streptococi, Staphylococci, Moraxella, Corynebacterium, and Neisseria.

Pasteurella multocida and Capnocytophaga canimorsus are particularly concerning due to their potential for antibiotic resistance and aggressive nature.

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Rabies is a serious disease that can be fatal if left untreated. It's estimated that approximately 55,000 people die from rabies each year, with most cases resulting from dog bites.

The risk of rabies infection from a dog bite depends on several factors. If the dog is not vaccinated against rabies, the risk is higher. In the United States, the most common source of the rabies virus is now wild animals, specifically raccoons, skunks, and bats.

Patients with a bite from a nonprovoked dog should be considered at higher risk for rabies infection than patients with a bite from a provoked dog. If the dog owner is reliable and can confirm that the animal's vaccination against rabies virus is current, the dog may be observed at the owner's home.

If the animal cannot be quarantined for 10 days, the dog bite victim should receive rabies immunization. Rabies immunization should begin within 48 hours after the bite, but it can be subsequently discontinued if the animal is shown to be free of rabies virus.

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Here are the guidelines for rabies immunization: